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Contact Information

LELAND W. PETERSEN, PSYCHOLOGIST, P.C.
11 BEECHWOOD DR
GLEN HEAD, NY11545-1101
 Phone: 516-671-7509
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LELAND W PETERSEN PSYCHOLOGIST PC · (Female)

NPI Number 1083831408
Status Active
Credentials
Entity Individual
Enumeration date 04/19/2007
Last updated 06/17/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 05430
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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